T1 weighted (T1w) postcontrast MR images are routinely obtained in patients examined for cerebral parenchymal and meningeal pathologies because they help to narrow the differential diagnosis in brain tumours (both metastases and primary cerebral tumours),
in subacute ischemic cerebral infarcts as well as in inflammatory and infectious cerebral diseases (1,2).
In clinical routine contrast enhanced T1w sequences usually are acquired as a 3D T1w gradient-echo sequence (1,2).
In our department with 1.5 T and 3 T Philips scanners,
a sagittal postcontrast 3D T1w TFE sequence is acquired with multiplanar reconstructions.
This sequence demonstrates a very good contrast between gray and white matter and allows a reliable detection of contrast enhancing lesions within the brain parenchyma and in the meninges.
However the detection of additional pathologic lesions in the neurocranium and the viscerocranium as well as in the soft tissues of the head and neck is prevented due to severe movement and susceptibility artefacts (3,4) and due to the missing fat suppression.
Tumorous and inflammatory / infectious pathologies often do not respect anatomic borders and thus are at the same time present in the brain parenchyma,
in the meninges,
in the osseous parts of the viscerocranium and neurocranium and in the soft tissue spaces of the head and neck (6-10).
Therefore we usually add at least one,
sometimes two postcontrast 2D m-Dixon T1w TSE sequences covering the soft tissues of the head and neck area and the viscerocranium and neurocranium.
These sequences need time to be acquired,
but patients with tumorous or infections pathologies usually are not in a good condition and do not tolerate a long MR examination.
Therefore we have aimed to develop a new postcontrast 3D T1w gradient-echo sequence that overcomes the limitations of the two formerly used sequences.
As a result a postcontrast 3D m-Dixon T1w TFE sequence,
named 3D m-Dixon T1w TFE GD,
has been developed acquired in sagittal plane of section and allowing multiplanar reconstructions.
The diagnostic reliability of this sequence has been compared to the original postcontrast 3D T1w TFE sequence in pathologies of the brain parenchyma and the meninges and has been compared to standard postcontrast 2D m-Dixon T1w TSE sequences in pathologies of the soft tissues in the head and neck area,
the neurocranium and the viscerocranium.
Our pictorial overview shows the diagnostic reliability of this new postcontrast 3D T1w m-Dixon TFE sequence in various pathologies of the orbit,
the temporomandibular joint,
the masticator space,
the mandible,
the oral cavity,
the paranasal sinuses,
the cavernous sinus and the adjacent foramina,
the superficial temporal artery,
the dura,
the leptomeninx,
the brain parenchyma and in the osseous parts of neurocranium and viscerocranium.